Reducing Hypertrophic Scar from Open Heart Surgery?

I had open heart surgery due to accident not internal problems. A hypertrophic scar formed in the middle of scar; it formed fine then turned flat and white. I did 585 pulsed dye and steroid injections and for the most part, scar has flattened, more so on top of scar than bottom. I want to recut the bottom of the scar, and a plastic surgeon said they would do a two layer stitch this time before they just stapled me down. Then after, apply aldara and maybe injections to be on the safe side. What you guys think?

Doctor Answers 5

Options for heart surgery scars

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I would defer to the surgeon who has personally examined you.  However, in most cases of chest scars and open heart surgery scars, I perform conservative therapy including IIT, laser, and pressure treatment to minimize recurrence. 

Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Scar revision after cardiac surgery

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The chest is notorious for formation of hypertrophic scars.  I agree that surgical excision would be appropriate and also recommend that you begin with a small segment of the scar and then evaluate whether this produces improvement.  If so, you can continue to undergo revision of the remaining portions of the scar.  Serial excision produces a small ultimate scar,which is desirable.  Additionally,  I would not use staples whatsoever in this area.  Suturing the wound will offer you the best chance at formation of a thinner, more aesthetically acceptable scar.  Definitely there are adjuvants which can be employed during the followup period including Cordran tape and early, consistent use of silicone sheeting.

Scar revision might work

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Scar revision sounds reasonable. I am not so sure about using Aldara on it afterward though. Get a few opinions before proceeding maybe.

Best Regards.

John P. Di Saia, MD
Orange Plastic Surgeon

Hypertrophic scar from open heart surgery

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I think that Aldara and cortisone injections (+/- 5-fluorouracil), the pulsed-dye laser, post-surgical massaging of the scar as well as silicone gel sheeting are useful adjuncts to scar revision. 

Good luck.

Bryan K. Chen, MD
San Diego Dermatologist

Hypertrophic scar management

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There is always a chance of having the hypertrophic scar come back again despite all the attempts. It is worth trying if it is bothering you .Your doctor is giving you all the right options. I'm not sure about the stapling part; it is better not to staple and close with the 2 or 3 layers. I would also add silicone sheets early after revision.

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 19 reviews

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